Division of Genitourinary Malignancies, Department of Medical Oncology Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
The introduction of targeted therapies has radically changed the treatment paradigm for metastatic renal cell carcinoma (mRCC). However, multiple clinical dilemmas have emerged. For instance, limited data are available to juxtapose the safety and efficacy profile of targeted therapies between older and younger adults. Herein, pivotal trials of vascular endothelial growth factor (VEGF)- and mammalian target of rapamycin (mTOR)-directed therapies are assessed in the context of their implications in treating older adults with mRCC. In general, subset analyses from these pivotal studies suggest similar efficacy of targeted therapies amongst older adults. Aging is accompanied by a multitude of physiological changes, as well as an increased prevalence of co-morbidities. The age-related toxicity profiles of targeted agents for mRCC are detailed to provide a framework for the risks and benefits of these therapies in older adults. Ultimately, tools such as the Comprehensive Geriatric Assessment (CGA) that account for physiological (as opposed to chronological) age may prove useful in the evaluation and treatment of older adults with mRCC.
Written by:
Pal SK, Vanderwalde A, Hurria A, Figlin RA. Are you the author?
Reference: Drugs Aging. 2011 Aug 1;28(8):635-49.
doi: 10.2165/11592880-000000000-00000
PubMed Abstract
PMID: 21812499
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